Purpose: The purpose of this study was to identify the duties and tasks of home visiting geriatric nurses using Development A Curriculum (DACUM) method. Method: The sample consisted of 107 geriatric visiting nurses who worked at community service centers in the Seoul metropolitan area. Job analysis was conducted at a DACUM workshop after that a web-based survey was given to participants to verify the accuracy of the duties and tasks of geriatric visiting nurse. Descriptive statistical analysis was conducted using SPSS 23. Results: A total of 8 duties and 56 tasks were identified as part of the job description of geriatric visiting nurses'. A task verification process was conducted. Overall mean ratings of the task importance were high. 'Recording' was identified as the most frequent duty, and 'Community program planning and operating' was identified as the most difficult duty. Conclusion: Duties and tasks that make up the job of geriatric visiting nurses were identified using the DACUM method. The resulting data will serve as the basis for the design of a curriculum development model for nurses involved in geriatric home visiting education programs, and will also be used to identify training needs and establish a standardized job description for geriatric visiting nurses.
Purpose: The aims of this study were to describe general characteristics and needs of home health care, and to find the differences between home health care needers and non-needers. Method: In this study, 642 subjects participated who lived in Muan, Jollanam-do. Data were collected in August 2001 using a self-reported questionnaire. The questionnaire was a revised and simplified form of the Organization of Community Health System Program at the Seoul National University. Collected data were analyzed through Kruskal-Wallis test. t-test. and Chi-squire for cross-sectional analysis. Result: The average age of the subjects was 52.6 years and 33.3% of them aged over 65 years. Twenty six percent of them had chronic degenerative diseases. The percentages of hypertension patients and D.M. patients were 6.4% and 2.5%, respectively. The number of family members was 2.95 on the average, 2.19 in cases of families with the elderly and 3.33 in cases of families without the elderly. The rate of disability of the elderly was 10.5%. Marital status (p=.000), the number of family members (p=.000), education (p=.000), job (p=.000) and health insurance (p=.027) were significantly different between home care needers and non-needers. Home care needers had less living expenses (p=.001), more frequent hospital admissions (p=.004), higher chronic disease rate (p=.000) and more frequent visits to public health center (p=.027) than non-needers. Home care needers who wanted free service were twice as many as non-needers. Conclusion: Home care need was very high in rural areas and the needers had worse characteristics (low educational level. low income, no job and no family). Therefore, it is necessary to develop cheaper and more accessible services for home care needers in rural areas.
This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.
The Journal of Korean Academic Society of Nursing Education
/
v.20
no.2
/
pp.321-331
/
2014
Purpose: The purpose of this study was to investigate the effects of case management service for hypertensive elderly patients through the customized visiting home health care program. Method: Non-equivalent control group pretest-posttest design was employed. Data were collected from April 2007 to January 2009. Among a total of fifty subjects, 25 subjects were belonged to the case management group and the others were belonged to the general management group. Results: 1) In experimental group, significant increasing rate of number of people within normal blood pressure by time, but no significant increasing rate of number of people within normal blood neutral fat, total cholesterol, HDL, & LDL. 2) In experimental group, the score of knowledge about disease and healthy life practice were increased on 8 week period but decreased on follow up period. Number of people within normal blood HDL and mean score of healthy life practice were significantly higher than control group on follow up period. Conclusion: Case management service was effective on controlling blood pressure but partly effective on blood lipid, knowledge about disease, and healthy life practice in hypertensive patients. Further study is needed to conduct a periodic re-evaluation of the effect of case management and to verify an optimal interval to provide the case management service.
Purpose: This study was conducted to evaluate health service delivery and attitudes, toward multi-cultural clients amongst community health practitioners (CHPs). Methods: A survey was conducted among 242 CHPs from December 10-22, 2015. The collected data were analyzed using chi-square test, t-test, and ANOVA using SPSS 18.0. Results: General awareness of multi-culturalism varied significantly by CHPs age and language ability. Additionally, utilization of services in accordance with the location of community health centers (CHCs) was significantly higher in rural areas than urban areas CHCs in post-partum maternal & neonate care giver service (in maternal child health), management of health educational programs and management of physical exercise (in implementing healthy life style) and networking resources in & outside of CHCs (in management of chronic disease). Conclusion: CHPs deliver health-care services to multi-cultural clients, but have not received sufficient training or education to serve these clients effectively. CHPs who received multi-cultural and foreign language training had more positive experiences with multi-cultural clients. This supports the needs for developing educational programs to enhance multi-cultural understanding amongst CHPs.
Journal of Korean Academy of Nursing Administration
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v.16
no.2
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pp.162-171
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2010
Purpose: Nursing home quality indicators have been focused widely on result outcomes, not for the environment in that quality of service are delivered, This study aimed to examine structural factors influencing quality management activities in nursing homes. Method: Sample was 170 nursing homes responded to the survey questionnaire which was distributed to the 543 nursing homes nation-wide, Data were collected on structural characteristics, types of services, and quality management activities, Data were analyzed with the descriptive statistics, Pearson correlations, and multiple regression. Result: Most of the nursing homes were operated as free of charge by the social welfare ownership. Average number of residents was 52.1 with severe and mild dementia and bedridden status, In terms of quality management activities, 34% of the sample had CQI committee that focused their activities on services delivery process, performance appraisal, record keeping regularly. 30.6% of quality management activities were accounted for by the number of residents with dementia, the ratio of RN to residents, rehabilitation services, and social wefare services in nursing homes. Conclusion: We recommend that more comprehensive quality management activities should be developed as process quality indicators in conjunction with the outcome indicators.
Purpose: This study was conducted to investigate patients' characteristics and actual conditions of home-based services offered by a free-standing hospice center. Methods: A retrospective review was performed with the medical records of 75 patients who received home-based hospice care from a free-standing hospice center from January 2014 through December 2014. Results: Most patients (54.7%) were enrolled via self-directed referral. The reason for the service termination was death at home 25.3%, admission to a hospice ward 50.7%, hospitalization 22.6% and patients' refusal 2.7%. Seventy three patients had cancer, and two patients had ALS. Among all, 58.7% were in a dying phase, and 34.7% were almost completely bedfast at the time of their enrollment in this study. When they enrolled, the patients' physical symptoms were characterized as pain (89.4%), sleep disturbance (71.2%), urinary difficulties (35.8%) and defecation difficulties (47.8%). Among all, 77.4% terminated the home visit service within one month. The mean frequency of the home visits was 3.25 (${\pm}3.98$), and less than five in 82.7% of patients. The mean frequency of the phone service was 3.40 (${\pm}3.12$). The frequency of doctor's home visits was $1.21{\pm}0.79$ on average, and the figure increased when patients' conditions turned unstable. Conclusion: It is necessary to develop a home-based hospice care model with consideration of patients' characteristics and the actual service conditions delivered by free-standing hospice facilities.
Objectives: This study was conducted to analyze the symptoms and care needs of home-based hospice palliative patients in Busan and to provide a basic reference for developing practical guidelines for their care. Methods: By examining the registration cards of 409 hospice palliative patients, who were registered in community health centers in Busan as of 2016, this study retrospectively analyzed their characteristics, symptoms and care needs. Results: The average age was 70.6 years, 59.4% were receiving medical benefits, and 48.4% lived alone. As per the data obtained from the Palliative Performance Scale, many were able to mobile. Fatigue was the most severe and depression and anxiety were reported together, and their care needs were also high. Most subjects reported mild or low pain, but care needs were high. Furthermore, the medical benefits group showed a high level of symptoms and care needs across areas. Conclusions: To help subjects to live in their homes for as long as possible, it is necessary to identify symptoms and care needs and provide services in accordance with their severity and situation. Thus, it is necessary to develop practical guidelines for standardized community hospice palliative care services.
The purpose of this research was to analyze the work performance and the general characteristics influencing work performance of customized home health care nurse. Research participants were 204 nurses who worked in the customized home health care of 33 public health centers in Daegu city and Gyeong-Buk Province. The data were collected by self report questionnaires from July, 1 to August, 30, 2011. The highest degree of work performance was the diabetes mellitus service, while the lowest degree was pregnant women services. Age, marital status, education level, religion, career at public health center, visiting nurses career and work area were the significant factors related to work performance in these subjects. Customized home health care nurses management policy which includes assignment tasks and employment security considering general characteristics of visiting nurses should be established to enhance of activation and stable settlement of customized home health care service.
Since the proportion of elderly citizens is increasing every year, the social interest is increasing for the health and the safety of the elderly. The nursing home is continually being created to care for more elderly people. However, the quality of service is not enough due to the lack of elderly caregivers. Elderly care and management services are being studied to replace the shortage of caregivers. Existing research for the implementation of an automatic care system has a high initial system cost. Furthermore, it lacks the ability to store and manage large amounts of data. In this paper, we propose a system that manages a large amount of data continuously generated through CCTV and provides a streaming service with a high level of quality-of-service (QoS) to users with collected video. Through the proposed system, it is possible to record and manage the behavioral information of the elderly occurring in the nursing home together with the video. In addition, according to the user's request, it has built a service that streams the video and behavioral information according to the date and time in real-time.
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